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Comnlete one Dage for each business in a"multinle business" annlications. <br />BVSMSS 'I'YPE <br />Please provide the following information on all the Operating Business(es) that will create/retain jobs and meet the LMI <br />goals for this Texas Capital Fund project. <br />Is the operating business: Z Existing ❑ To be established. When? <br />~ Corporation <br />❑ Limited Liability Co. <br />❑ Limited Partnership <br />❑ General Parinership <br />❑ Sole Proprietorship <br />C7 <br />z <br />Type of Business: El <br />Primary NAICS/SIC code of business: <br />R <br />~ <br />BUSINESS INFflRMATION <br />V <br />Full legal business name (owner's name if sole proprietar - no aliases) <br />~ <br />Daisy Brand, Inc. <br />D.B.A. (if applicable) <br />Federal Taxpayer ID No. <br />DLTN's Number (required) <br />Physical Location of Project: <br />Census Tract: <br />Block Group: <br />FERSON TO C(jNTE4CT usiness) <br />Z Mr. F~ Mrs. <br />First Name <br />M. I. <br />Last Name <br />❑ Ms. ❑ <br />David <br />Sokolsky <br />x <br />Title <br />Primary Phone <br />Z <br />Owner <br />( ) - Ext. <br />O <br />H <br />Secondary Phone (optional) <br />Fax (optional) <br />W <br />( ) - Ext. <br />( ) - Ext. <br />~ <br />E-mail <br />Would you prefer to be contacted by E-mail? <br />dsokolsky(~a,daisvbrand.com <br />~ Yes ❑ No <br />~ <br />MAILfNG ADDRESS <br />z <br />Address <br />O <br />F <br />City <br />State <br />Zip <br />County <br />W <br />cn <br />JQB CREA'TIQN IlNFORMATION <br />~ <br />Total number of jobs to be created <br />179 <br />z <br />~ <br />Total number of jobs to be retained <br />0 <br />E~ <br />W <br />Total number of Low and Moderate Income jobs to be created <br />90 <br />~ <br />Total number of Low and Moderate Income jobs to be retained <br />0 <br />~ `~I <br />